Effect of corticosteroids in addition to intravenous gamma globulin therapy on serum cytokine levels in the acute phase of Kawasaki disease in children - 29/08/11
, Makoto Shinohara, MD, Tomio Kobayashi, MD, Yoshinari Inoue, MD, Takeshi Tomomasa, MD, Tohru Kobayashi, MD, Akihiro Morikawa, MD
Reprint requests: Yasunori Okada, MD, Department of Pediatrics, Gunma University School of Medicine, Showa-machi 3-39-22, Maebashi, Gunma 371-8511, Japan.for the Gunma Kawasaki Disease Study Group (Appendix)
Abstract |
Objective |
The aim of this multicenter prospective and randomized study was to determine the effect of adding corticosteroids to intravenous gamma globulin (IVGG) therapy on serum cytokine levels, as well as to see its effect on the clinical course in children in the acute phase of Kawasaki disease (KD).
Study design |
Patients with KD (n=32) were randomized to receive either IVGG alone (G group) or IVGG plus corticosteroids (G+S group). The clinical course and cytokine responses between groups were compared.
Results |
The pretreatment serum levels of interleukin (IL)-2, IL-6, IL-8, and IL-10 were significantly higher in patients with KD than in healthy controls. Although IVGG alone failed to reduce cytokine concentrations within 24 hours of IVGG administration, corticosteroids plus IVGG reduced IL-2, IL-6, IL-8, and IL-10 levels. The levels of IL-2, IL-6, IL-8, and IL-10 within 24 hours after initiating IVGG therapy were significantly lower in the G+S group than in the G group. The duration of fever was shorter, and the C-reactive protein concentration decreased more quickly in the G+S group than in the G group.
Conclusions |
These findings suggest that corticosteroids rapidly ameliorate symptoms by reducing cytokine levels in children with KD.
Le texte complet de cet article est disponible en PDF.Abbreviations : CRP, IFN, IL, IVGG, KD, TNF
Plan
Vol 143 - N° 3
P. 363-367 - septembre 2003 Retour au numéro
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